know more about Treatment of Stroke

Overview

Stroke, also termed Cerebrovascular accident (CVA), is a medical condition in which the blood vessel supplying the brain gets ruptured and starts bleeding, or there is a blockage in the blood vessel. Either of the two factors mentioned above prevents the blood and oxygen from reaching the brain cells resulting in the destruction and even death of the brain tissues. As a result, the patient starts experiencing several complications like speaking difficulties, paralysis of one side of the body, memory loss, and even death in severe cases. It contributes to a major and leading cause of death and disability in the younger population.

There are three primary types of strokes:

• This occurs when the blood supply to a part of the brain is insufficient for a very short period and involves a blood clot that typically reverses on its own. It is also called Ministroke.
• This occurs when there is a blockage in the blood supply of the brain caused either due to a clot or plaque in the artery. It accounts for the majority of the cases, and the symptoms and complications of ischaemic stroke can last longer than those of a TIA or may become permanent.
• This takes place when there is a rupture in a blood vessel on the surface of the brain, and the space between the brain and the skull gets filled with blood. This type of stroke accounts for nearly 20% of the cases. It is further divided into Intracerebral and Subarachnoid hemorrhages.

Treatment

Ischaemic Stroke

To treat an ischemic stroke, the doctor focuses on restoring blood flow to the brain. This can be achieved with the following things:

Treatment with thrombolytic drugs helps in the breakdown of clots and thereby reduces the damage to the brain. It has to be given within 3 to 4 hours from the time when symptoms first appear. An IV injection of recombinant tissue plasminogen activator (TPA), also called Alteplase (Activase) or Tenecteplase (TNKase), is the standard line of treatment for Ischaemic stroke.

These are as follows:

• Medications are delivered directly to the brain.
• Endovascular Thrombectomy.

Other procedures apart from these, various other options include:

• Carotid arteries run along the neck and supply the brain with blood. This procedure helps remove the plaque by making an incision in the carotid artery, thereby reducing the risk of ischemic stroke. The doctor then repairs the artery and sutures it with a graft.
• In this procedure, the doctor inserts a balloon-tipped catheter into the carotid arteries through an artery in the groin. The balloon is inflated to expand the narrowed artery, and a stent can be inserted to support the opened artery.

Hemorrhagic Stroke

The treatment of hemorrhagic stroke emphasizes bleeding control and decreasing the pressure in the brain caused by the accumulation of excessive fluid. Treatment options include:

• Apart from blood-thinning medications, the patient is administered drugs to lower the intracranial pressure in the brain, lower blood pressure and prevent seizures.
• It is recommended if the area of the bleeding is large. Surgery is performed to remove the blood, relieve pressure on the brain, and repair blood vessel problems associated with haemorrhagic strokes.
• Through this procedure, doctors remove a smaller Arteriovenous malformation if it’s located in an accessible area of the brain, thereby eliminating the risk of rupture and reducing the risk of hemorrhagic stroke.
• This is an advanced minimally invasive treatment used to repair blood vessel malformations.
• Using a catheter inserted into an artery in the groin and guided to the brain, the surgeon will place tiny detachable coils into the aneurysm to fill it. This blocks blood flow into the aneurysm and causes blood to clot.
• A surgeon inserts a tiny clamp at the base of the aneurysm to prevent blood flow to it. This clamp can prevent the aneurysm from bursting also.